56。Therearepersonswho，frombirthorfromdisease，havedislocationsoutwardofboththethighs；inthem，then，thebonesareaffectedinlikemanner，butthefleshypartsintheircaselosetheirstrengthless；thelegs，too，areplumpandfleshy，exceptthatthereissomelittledeficiencyattheinside，andtheyareplumpbecausetheyhavetheequaluseofboththeirlegs，forinwalkingtheytotterequallytothissidethat。Theirnatesappearveryprominent，fromthedisplacementofthebonesofthejoint。Butifintheircasethebonesdonotsphacelate（becomecarious？）andiftheydonotbecomebentabovethehip—joint，ifnothingofthiskindhappentothem，theybecomeotherwisesufficientlyhealthy，butthegrowthofalltherestofthebody，withtheexceptionofthehead，isarrested。
57。Indislocationsoftheheadofthefemurbackward，whichrarelyoccur，thepatientcannotextendtheleg，eitheratthedislocatedjoint，orattheham，toanyextent，andofallthedislocations，thisisthevarietyinwhichthepatientshavetheleastpowerofmakingextensionatthegroinandtheham。But，moreover，thisalsoshouldbeknown（foritisavaluablepieceofknowledge，andofmuchimportance，andyetmostyetmostpeopleareignorantofit），thatpersonsinhealthcannotextendthejointattheham，iftheydonotextendthejointatthegroinatthesametime，unlesstheyraisethefootveryhigh，forinthiswaytheycoulddoit；
neitheralsocouldtheybendthejointattheham，butwithmuchgreaterdifficulty，iftheydonotbendthejointatthegroinatthesametime。Therearemanyotherthingsinthebodywhichhavesimilarconnections，bothwithregardtothecontractionsofnerves（ligaments？），andthepositionsofmuscles，andmanyofthemmoreworthyofbeingknownthanisgenerallysupposed，andwithregardtothenatureoftheintestineandthatofthewholeinternalcavity，andwithregardtothedisplacementsandcontractionsoftheuterus；butallthesethingswillbetreatedofelsewhere，inaworkakintothepresentone。Butwithregardtothematteronhand，theycannotmakeextension，ashasbeenalreadystated；andthelimbappearsshortened，fortworeasons—first，becauseitcannotbeextended，andalsobecausethebonehasslippedintothefleshofthenates；fortheheadandneckofthefemur，inthisdislocation，arecarrieddownwardfromtheirnaturalsituation，totheoutsideofthenates。Butyettheycanbendthelimb，unlesspreventedbypain，andthelegandfootappearprettystraight，andnotmuchinclinedtowardeitherside，butatthegrointheflesh，whenfelt，appearslooser，fromtheboneofthejointhavingslippedtotheotherside，butatthenatestheheadofthefemurmaybefelttobemoreprominentthannatural。Sucharethesymptomsaccompanyingdislocationofthethighbackward。
58。Whenthisdislocationoccursinanadult，andisnotreduced，hecanwalk，indeed，afteratime，andwhenthepainhasabated，andwhenhehasbeenaccustomedtorotatethearticularboneintheflesh；hefindsitnecessary，however，tomakestrongflexionatthegroininwalking，fortworeasons，bothbecausethelimb，forthecausesalreadystated，becomesmuchshorter，andheisfarfromtouchingthegroundwithhisheel，andhecanbarelyreachitwiththeballofhisfoot，andnoteventhus，unlesshebendhimselfatthegroins，andalsobendwiththeotherlegattheham。Andinthiscase，heisunderthenecessityofsupportingtheupperpartofthethighwithhishandateachstep：thisalsocontributes，inacertaindegree，tomakehimbendthebodyatthegroins；for，duringtheshiftingofthefeetinwalking，thebodycannotbesupportedontheunsoundbesupportedontheunsoundlimb，unlessitbepressedtothegroundbythehand，—theendofthefemurnotbeingplacedproperlyunderthebody，buthavingslippedbackwardtothenates；andifheshouldtrytoresttheweightofhisbodyforalittle，uponthefoot，withoutanyothersupport，hewouldfallbackward，fortherewouldbeagreatinclinationinthisdirection，fromthehipshavingprotrudedbackwardfarbeyondthelineofthefoot，andthespineincliningtowardthehips。Suchpersonscanwalk，indeed，withoutastaff，ifsoaccustomed，forbecausethesoleofthefootisinitsoldline，andisnotinclinedoutward，theydonotrequireanythingtobalancethem。Such，however，as，insteadofgraspingthethigh，preferrestingtheirweightuponastaffintroducedintothearmpitoftheaffectedside，these，iftheyusealongerstaff，willwalk，indeed，moreerect，butwillnotbeabletoreachthegroundwiththefoot，oriftheywishtorestuponthefoot，theymusttakeashorterstaff，andwillrequiretobendthebodyatthegroins。Thewastingofthefleshypartsisanalogoustowhathappensinthecasesformerlydescribed，forthewastingisgreatestinthosecasesinwhichthepatientskeepthelimbup，anddonotexerciseit，whilstthosewhopracticewalking，havetheleastatrophy。Thesoundleg，however，isnotbenefited，butisratherrenderedmoredeformed，iftheinjuredlimbbeappliedtotheground，foritisforcedtocooperatewiththeother，beingprotrudedatthehip，andbentattheham。Butifthepatientdoesnotusetheinjuredlimbbyapplyingittotheground，butcarriesitup，andrestsuponastaff，thesoundlegtherebygainsstrength，foritisemployedinitsnaturalposition，andfurther，theexercisegivesitstrength。Butitmaybesaid，thesethingsareforeigntomedicine；forwhatistheuseofenlarginguponcaseswhicharealreadypastremedy？Thisisfarfrombeingthecase，foritbelongstotheknowledgeofmedicinetobeacquaintedalsowiththese，andtheycannotpossiblybeseparatedfromoneanother；fortosuchasarecurable，meansaretobeusedtopreventthemfrombecomingincurable，studyinghowtheymaybestbepreventedfromgettingintoanincurablestate。Andincurablecasesshouldbeknown，thattheymaynotbeaggravatedbyuselessapplications，andsplendidandcreditableprognosticsaremadebyknowingwhere，how，andwheneverycasewillterminate，andwhetheritwillbeconvertedintoacurableoranincurabledisease。Whenthen，frombirth，orduringone’syouth，thisdislocationbackwardoccurs，andisnotreduced，whetheritbeconnectedwithviolenceordisease（formanysuchdislocationsoccurindiseases，butthenatureofthediseasesinwhichdislocationstakeplace，willbedescribedafterward）；if，then，thedislocatedlimbbenotreduced，theboneofthethighbecomesshortened，thewholelimbisimpaired，isarrestedinitsgrowth，andlosesitsfleshfromwantofuse；thearticulationatthehamisalsoimpaired，forthenerves（ligaments？）becomestretched，fromcasesformerlystated，whereforethosewhohavethisdislocation，cannotmakeextensionattheknee—joint。Inaword，allpartsofthebodywhichweremadeforactiveuse，ifmoderatelyusedandexercisedatthelabortowhichtheyarehabituated，becomehealthy，increaseinbulk，andbeartheiragewell，butwhennotused，andwhenleftwithoutexercise，theybecomediseased，theirgrowthisarrested，andtheysoonbecomeold。Amongthesepartsthejointsandnerves（ligaments？），ifnotused，arenottheleastliabletobesoaffected；
theyareimpaired，then，forthereasonswehavestated，moreinthisvarietyofdislocationthanintheothers，forthewholelimbiswasted，bothinitsbonesandinitsfleshyparts。Suchpersons，then，whentheyattaintheirfullgrowth，keepthelimbraisedandflexed，resttheweightofthebodyontheotherleg，andsupportthemselveswithastaff，somewithone，andotherswithtwo。